Made available in DSpace on 2014-06-11T19:31:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-07-04Bitstream added on 2014-06-13T20:01:37Z : No. of bitstreams: 1 pereira_rsc_dr_botfm.pdf: 7258621 bytes, checksum: 700f64c9060e3819c2ef6cd7d90e560c (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O consumo abusivo de álcool é considerado um grave problema de saúde pública mundial. O uso excessivo e indiscriminado de bebidas alcoólicas é responsável por mais de 60 agravos a saúde, como câncer de esôfago, estômago e fígado, doenças cardiovasculares, cirrose hepática, pancreatite crônica, úlcera péptica e em muitas dessas patologias pode-se necessitar de intervenções no trato digestivo. Na problemática exposta sobre o alcoolismo há uma série de alterações que podem repercutir nas anastomoses do trato gastrointestinal, como: desnutrição, lesões hepáticas, além do efeito tóxico direto do etanol sobre a mucosa gastrointestinal. Estudar o efeito do alcoolismo no processo de cicatrização intestinal e a evolução no pós-operatório de ratos submetidos à ingestão de etanol. Método: Foram utilizados 160 ratos da linhagem Wistar. Esses animais foram divididos em dois grupos, controle e tratado, sendo que o controle recebeu água e ração em livre demanda e o tratado solução etílica a 30% e ração livre demanda. Após 180 dias foi realizada colotomia cinco centímetros acima da deflexão peritoneal e anastomose em todos os animais. Após o procedimento os grupos foram divididos em quatro subgrupos de 20 ratos para estudo nos seguintes momentos: 40, 70, 140 e 210 pós-operatórios. Os parâmetros analisados foram: força de ruptura longitudinal, dosagem de hidroxiprolina tecidual, complicações pós-operatórias e estudo histopatológico. Resultados: O ganho de peso foi superior no grupo controle quando comparado com o grupo tratado (p<0,05). Agrupados todos os subgrupos, a força de ruptura foi significativamente maior no grupo controle que no grupo tratado (p<0,05). A dosagem de hidroxiprolina não apresentou diferença entre os grupos em cada momento estudado. A análise histopatológica não demonstrou alterações significativas entre... / Alcohol abuse is considered to be a serious public-health problem worldwide. The excessive and indiscriminate use of alcoholic beverages is responsible for more than 60 health medical problems, such as esophageal, stomach and liver cancer, cardiovascular diseases, hepatic cirrhosis, chronic pancreatitis and peptic ulcers. Many of these pathologies may require interventions in the digestive tract. The problems stemming from alcoholism include a number of alterations that may lead to anastomosis of the gastrointestinal tract, such as malnutrition and hepatic lesions, in addition to the direct toxic effect of ethanol on the gastrointestinal mucosa. Objective: To study the effect of alcoholism on the process of intestinal healing and the post-operative development of rats submitted to ethanol ingestion. Method: One hundred and sixty Wistar rats were used. These animals were divided into two groups, namely control and treated. The control group received water and animal feed ad libitum, and the treated group was given 30% ethyl alcohol solution and feed ad libitum. One hundred and eighty days later, colotomy 5 cm above peritoneal deflection and anastomosis were performed in all animals. After the procedure, the groups were divided into 4 sub-groups of 20 rats for study at the following post-operative moments: 4th, 7th, 14th and 21st days. The parameters analyzed were rupture strength, tissue hydroxyproline dosage, post-operative complications and histopathology. Results: Weight gain was greater in the control group as compared to that in the treated group (p<0.05). By grouping all the sub-groups, it was observed that rupture strength was significantly greater in the control group than in the treated group (p<0,05). Hydroxyproline dosage did not show any differences between the groups at each studied moment. Histopathological analysis did not show significant alterations between the groups... (Complete abstract click electronic access below)

Estudo quantitativo, exploratório, descritivo e transversal, com objetivo de avaliar o manejo do intestino neurogênico e sua relação com a qualidade de vida (QV), satisfação e estilo de vida em pessoas com lesão medular traumática (LMT). Seguidos os preceitos éticos, a amostra foi composta por 81 adultos com LMT, de dois centros de reabilitação dos estados de São Paulo e Santa Catarina. Os dados foram coletados a partir de cinco instrumentos previamente validados (questionários sociodemográfico e de caracterização da LMT, Índice de Tratamento do Intestino e da Bexiga (BBTI) e dois data sets de função intestinal e QV desenvolvidos pela International Spinal Cord Society (ISCoS)). Foram realizadas análises descritivas e correlacionais. A maioria dos participantes era do sexo masculino, jovens, com idade média de 36 anos no momento da lesão, baixa escolaridade, beneficiários da previdência social, com baixa renda familiar (até três salários mínimos) e com a LMT no nível torácico. As principais causas da LMT foram acidentes de trânsito e queda, o tempo médio da LMT era de 4,7 anos. Os participantes utilizavam principalmente medidas conservadoras (massagem abdominal, manobra de Valsalva e estímulo dígito-anal) como método para esvaziamento intestinal. Cerca de 90% necessitava de até 30 minutos para o manejo intestinal, e tinha frequência de defecação acima de duas vezes por semana. Aproximadamente metade dos participantes relatou incontinência fecal. A independência para o cuidado intestinal não foi associada ao nível da LMT, no entanto esteve associada à satisfação com a rotina de cuidados intestinais e ao tempo da LMT, assim quanto maior o tempo de lesão, maior foi a independência para o manejo intestinal. Aproximadamente 40% e 35% referiram alterar suas rotinas diárias devido à incontinência fecal e constipação, respectivamente. O impacto na QV devido aos problemas intestinais foi relatado por 77,8% da amostra. Não houve diferença estatisticamente significativa entre QV geral, com a saúde psicológica e com a saúde física (p>0,05). A QV geral esteve associada ao tempo de LMT, e foi menor entre as pessoas que tiveram que alterar suas rotinas devido a perdas fecais e entre aquelas que precisavam utilizar fraldas. As pessoas satisfeitas com suas rotinas de cuidado intestinal apresentaram maior QV geral e maior satisfação com a saúde psicológica. Ainda há que se progredir na reabilitação intestinal das pessoas com LMT, desenvolvendo estratégias de capacitação para o manejo intestinal, com a finalidade de reduzir os fatores que impedem ou dificultam a pessoa com LMT a retornar para suas atividades sociais e laborais, acarretando prejuízos na vida pessoal e para a economia do país já que a maioria dessas pessoas era economicamente ativa e agora dependem da previdência social e dos serviços de saúde com mais frequência. Os achados deste estudo podem subsidiar a prática clínica nos serviços de reabilitação, considerando que um programa de reabilitação precocemente iniciado e individualmente planejado pode auxiliar a pessoa com LMT a ter um funcionamento intestinal adequado e consequentemente uma melhor QV, satisfação e estilo de vida / Quantitative, exploratory, descriptive and transversal study, with the aim to assess the management of the neurogenic intestine and its relationship with the quality of life (QOL), satisfaction and lifestyle on people with traumatic spinal cord injury (TSCI). In accordance with the ethical requirements, the sample was composed by 81 adults with TSCI, from two rehabilitation centers from the states of Sao Paulo and Santa Catarina. The data was collected from five previously validated instruments (socio-demographic questionnaires and of characterization of TSCI, Index of Bladder and Intestine Treatment (BBTI) and two data sets of intestinal function and QOL developed by the International Spinal Cord Society (ISCoS)). Descriptive and correlational analyses were carried out. Most of the participants were male, young, with an average age of 36 years at the time of the injury, low schooling, and social security beneficiaries with low family income (up to three minimum wages) and with the TSCI at thoracic level. The main causes of the TSCI were traffic accidents and falls, the average time TSCI was of 4.7 years. Participants used mainly conservative measures (abdominal massage, Valsalva maneuver and digital anal stimulus) as a method for bowel emptying. Around 90% needed up to 30 minutes for the intestinal management, and had defecation frequency above twice a week. Approximately half of the participants reported fecal incontinence. Intestinal care independence was not associated with the level of the TSCI, however it was associated with satisfaction with bowel care routine and to the time of TSCI, so the longer the time of injury, the greater the independence for the bowel management was. Approximately 40% and 35% reported altering their daily routines due to fecal incontinence and constipation, respectively. The impact on the QV due to intestinal problems was reported by 77, 8% of the sample. There was no significant statistical difference between general QOL with psychological health and physical health (p>0,05). General QOL was associated with the time of TSCI and was lower among the people who had to alter their routines due to fecal losses and among those who needed to use diapers. The people satisfied with their routines of intestinal care presented higher general QOL and higher satisfaction with their psychological health. There is still progress to be made in the intestinal rehabilitation of people with TSCI, developing training strategies for the intestinal management, with the purpose to reduce the factors that prevent people with TSCI to return to their social and labor activities, causing losses in personal life and for the country\'s economy since most of these people were economically active and now depend on social welfare and health services more frequently. The findings of thid study can provide clinical practice in rehabilitation services, considering that a rehabilitation program prematurely launched and individually planned can assist the person with TSCI to have proper bowel function and consequently a better QOL, satisfaction and lifestyle

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / Objetivo: Avaliar os efeito da ornitina &#945;-cetoglutarato (OKG) no sangue e tecido intestinal de ratos submetidos à isquemia/reperfusÃo intestinal atravÃs da determinaÃÃo das concentraÃÃes in vivo no sangue e no tecido do intestino delgado, submetido a isquemia/reperfusÃo, de glicose, G 6 PDH, piruvato, acetoacetato, lactato, 3 HBDH, glutationa, T-Bars, mieloperoxidase, CPK e LDH. MÃtodo: Sessenta ratos (Rattus norvergicus albinus, Rodentia Mammalia) foram distribuÃdos aleatoriamente em cinco grupos de 12 animais: Sham 0â (s0â), Sham 30â (s30â), Sham 60â (s60â), Isquemia (i30â), ReperfusÃo (r30â). Estes grupos foram distribuÃdos em subgrupos de acordo com o tempo e com o composto utilizado na gavagem. Todos os animais receberam gavagem de caseinato de cÃlcio ou OKG em dose Ãnica, trinta minutos antes da laparotomia exploradora (LE). Os subgrupos s0âCaCa s30âCaCa, s60âc, i30âCaCa e r30âCaCa receberam apenas caseinato, de cÃlcio. Os subgrupos s0âOKG, s30âOKG, s60âOKG, i30âOKG e r30âOKG receberam OKG na dose de 5g/kg de peso. As amostras foram colhidas em cinco momentos: imediatamente apÃs a LE; apÃs 30 minutos da LE; ApÃs 1h da LE; ApÃs 30 minutos de isquemia; ApÃs 30 minutos de reperfusÃo. A estatÃstica discritiva foi expressa atravÃs da mÃdia, erro e desvio padrÃo, acompanhando-se pelo intervalo de confianÃa da mÃdia a 95% . Para comparar os valores prà e pÃs-procedimentos nas concentraÃÃes das variÃveis estudadas foram empregados os teste âtâ de Student pareado (para variÃncia homogÃnea e heterogÃnea) e ANOVA apÃs anÃlise de normalidade atravÃs do teste Kolmogorov-Smirnov. Quando observou a nÃo normalidade aplicou-se o teste de Kruskal-Wallis. Resultados: Os resultados apontaram um aumento significativo na lactacemia (1.186 + 0,18 versus 0,794 + 0,06, p<0,01) nos animais que receberam OKG em relaÃÃo ao controle nos subgrupos isquemia trinta minutos (i30â). No tecido intestinal reperfundido (r30â) ocorreu reduÃÃo significativa da concentraÃÃo de lactato (0,107 + 0,01 versus 0,266 + 0,02, p<0,05) nos animais recipientes de OKG em relaÃÃo ao animais controle, O piruvato plasmÃtico e tecidual se mostrou significantemente reduzido (0,146 + 0,24 versus 0,156 + 0,17 e 0,094 + 0,02 versus 0,248 + 0,03, p<0,05) apÃs o perÃodo de reperfusÃo de trinta minutos nos animais recipientes da OKG em relaÃÃo aos animais controle. Houve reduÃÃo significativa da concentraÃÃo do acetoacetato no tecido intestinal nos tempos pÃs isquemia e pÃs reperfusÃo dos animais recipientes da OKG (0,57 + 0,01 versus 0,0685 + 0,01 e 0,128 + 0,04 versus 0,156 + 0,03,*p<0,05) quando comparados ao animais nÃo tratados. A glicose 6 PDH apresentou reduÃÃo significativa da sua concentraÃÃo plasmÃtica no tempo isquemia trinta minutos dos animais recipientes da OKG em relaÃÃo aos nÃo tratados ( 0,1442 + 0,048 versus 1,1098 + 0,0796, *p<0,05) , ocorrendo o mesmo na concentraÃÃo tecidual, no pÃs isquemia (0,1002 + 0,02 versus 0,147 + 0,0264, p<0,05). A LDH apresentou elevaÃÃo significativa da sua concentraÃÃo nos animais recipientes da OKG em relaÃÃo ao controle (278,01 + 51,52 versus 132,93 + 12,54, *p<0,05) no grupo isquemia (i30â) . Ocorreu reduÃÃo significativa da CPK no grupo reperfusÃo (r30â) dos animais recipientes da OKG em comparaÃÃo aos animais controle (115,13 + 11,77 versus 166,70+6,23,p<0,05). A glutationa tecidual apresentou elevaÃÃo significativa no sham OKG 30 minutos em relaÃÃo ao nimais controle (59,17 + 2,39 versus 25,09 + 1.53, p<0,05) e reduÃÃo significante no tempo isquemia, tanto nos animais OKG quanto CaCa. Durante o perÃodo de reperfusÃo a glutationa nÃo apresentou alteraÃÃes significativas entre os animais tratados e controle. A OKG influenciou de maneira significativa na reduÃÃo da concentraÃÃo da 3HDBH tecidual no tempo i30â (0,062 + 0,01 versus 0,075 + 0,02,p<0,01) Esta diferenÃa significativa foi mantida no sangue dos animais tratados no grupo reperfusÃo 30âOKG em relaÃÃo aos animais r30âCaCa (0,03 + 0,00 versus 0,0615 + 0,01, p<0,01). A T-bars tecidual apresentou reduÃÃo significante no grupo r30âOKG em comparaÃÃo ao r30âCaCa (0,0522 + 0,03 versus 0,0745 + 0,02, p<0,05), com elevaÃÃo significativa no grupo sham 60âCaCa em relaÃÃo aos animais tratados 0,0937 + 0,02 versus 0,020 + 0,01, p<0,01). A oferta exÃgena da alfa-cetoglutarato nÃo ocasionou nenhuma alteraÃÃo significante nas concentraÃÃes de glicose e mieloperoxidase (MPO) entre os animais do subgrupo experimento quando comparados aos do subgrupo controle. ConclusÃes: Os procedimentos realizados foram suficientes para desencadear alteraÃÃes significativas em alguns metabÃlitos estudados. O modelo de isquemia-reperfusÃo demonstrou efetividade. A oferta exÃgena OKG, em dose Ãnica por gavagem, sugere aumento na atividade prÃ-glicolÃticas aerÃbica a nÃvel tecidual e sistÃmico; proteÃÃo contra lesÃo celular do tecido intestinal, e efeito antioxidante tecidual e sistÃmico durante a lesÃo de isquemia e apÃs a lesÃo de reperfusÃo / Objective: To evaluate the effect of ornithine alpha-ketoglutarate (OKG) in the blood and intestinal tissue of rats submitted to intestinal ischemia/reperfusion, using the blood concentrations of glucose, G6PDH, pyruvate, acetoacetate, lactate, 3HBDH, glutathione, T-Bars, myeloperoxydase, CPK and LHD, evaluated in vivo on these tissues. Methods: Sixty rats (Rattus norvergicus albinus, Rodentia Mammalia) were selected and aleatorily distributed in five groups of twelve animals, which were: Sham0â(s0â), Sham30â(s30â), Sham60â(s60â), Isquemia(i30â), ReperfusÃo(r30â). These groups were distributed in subgroups according to the time and the compost used to the âgavagemâ. All de animals received the âgavagemâ with calcium caseinate or okg, only one dosage, thirty minutes before the exploratory laparotomy (EL). The subgroups s0âCa, s30âCa, s60âCa, i30âCa and r30âCa received only calcium caseinate. The subgroups s0âokg, s30âokg, s60âokg, i30âokg and r30âokg received 5g of okg par each kilogram. The samples were taken in five moments: immediately passed the EL; passed 30 minutes of the EL; passed 60 minutes of the EL; passed 30 minutes of the isquemia; passed 30 minutes of the reperfusion. The descriptive statistics were media, error and standard deviation. The values before and after the procedures were compared using the âtâ test (âStudent pareadoâ to homogeny and heterogeny variation) and ANOVA. Then, it was used Kolmogorov-Smirnov to compare the normal results. The results were not normal, it was used the Kruskal-Wallis test. Results: It was shown an improvement on the blood lactate(1.186 + 0,18 versus 0,794 + 0,06, p<0,01) to the animals that received okg from i30â. A reduction on blood lactate lactato (0,107 + 0,01 versus 0,266 + 0,02, p<0,05) was noticed in the group r30â that received okg. It occurred a reduction on plasmatic and tissue pyruvate reduzido (0,146 + 0,24 versus 0,156 + 0,17 and 0,094 + 0,02 versus 0,248 + 0,03, p<0,05) to the group r30â that received okg. The acetoacetate was reduced to both groups, isquemia and reperfusion, that received okg0,57 + 0,01 versus 0,0685 + 0,01 e 0,128 + 0,04 versus 0,156 + 0,03,*p<0,05). The plasmatic glucose was reduced to the group i30â( 0,1442 + 0,048 versus 1,1098 + 0,0796, *p<0,05) treated with okg and the same happened to the tissue glucose after isquemia (0,1002 + 0,02 versus 0,147 + 0,0264, p<0,05). The LDH had an improvement (0,1002 + 0,02 versus 0,147 + 0,0264, p<0,05) to the group i30â treated with okg. CPK was reduced (115,13 + 11,77 versus 166,70+6,23,p<0,05) to the group r30â treated with okg. The tissue glutathione had an improvement to sham okg 30â (59,17 + 2,39 versus 25,09 + 1.53, p<0,05) and a reduction on isquemia period to the animals treated with okg and CaCa . 3HBDH was reduced (0,062 + 0,01 versus 0,075 + 0,02,p<0,01) in the blood and in the tissues from i30â. This difference was kept to animalsâ blood from r30âokg when related to r30âCaCa(0,03 + 0,00 versus 0,0615 + 0,01, p<0,01). There was a reduction on tissue T-BARS to r30âOKG when compared to r30âCaCa(0,0522 + 0,03 versus 0,0745 + 0,02, p<0,05) and an improvement to sham60âCaCa(0,0937 + 0,02 versus 0,020 + 0,01, p<0,01). Glicose and Myeloperoxydase were not affected by the use of okg. All the results were compared to the respective control groups. Conclusion: The used procedures could bring useful results to metabolites in study. The isquemia/reperfusion showed efficiency, offering exogen okg leads to a rising on glicolitic and aerobic activity to tissues and systems. This offer protects yet from the tissue injury and has antioxidant effect during the isquemia/reperfusion injury.

A estrongiloidíase é uma parasitose intestinal sendo considerada a quarta maior causada por nematódeos. O mecanismo de defesa contra a estrongiloidíase é mediada pela ativação de células de perfil Th2, que amplificam a resposta celular através da secreção de mediadores inflamatórios. O que faz da estrongiloidíase um grave problema de saúde pública, é o desenvolvimento da hiperinfecção, principalmente devido ao uso de glicocorticóides, onde ocorre aumento do número de larvas e fêmeas que se disseminam por todo organismo. Estudos demonstraram que algumas infecções helmínticas têm sido acompanhadas por hipertrofia e hipercontratillidade da musculatura intestinal, via JAK-STAT 6. Entretanto pouco se sabe sobre a influência desta via nas alterações da parede muscular do duodeno durante infecção pelo Strongyloides venezuelensis. O presente trabalho objetivou investigar as alterações morfológicas, imunológicas e patológicas da musculatura lisa intestinal que ocorrem em decorrência da infecção experimental pelo S. venezuelensis, bem como a interferência do tratamento com Dexametasona e o papel da via JAK - STAT 6 neste processo. Ratos Wistar foram inoculados com larvas de S. venezuelensis, tratados com dexametasona e sacrificados nos dias 5, 7, 14 e 21. Foram realizadas diversas colorações com a finalidade de quantificar as fêmeas adultas no duodeno, realizar morfometria da musculatura duodenal, quantificar eosinófilos e células caliciformes. Foi realizada análise da expressão gênica do gene STAT 6. Nossos resultados mostraram hiperplasia das células caliciformes, infiltrado eosinofílico e espessamento da musculatura lisa duodenal. Houve aumento na expressão de STAT 6 nos animais infectados. O tratamento com a Dexametasona inibiu drasticamente estas alterações. Entretanto o número de parasitas foi significativamente maior nos ratos infectados tratados quando comparados aos infectados. As alterações intestinais durante a infecção ocorreram na tentativa de expulsar o parasita e resolução da infecção. Contudo, a inibição deste processo provocada pela Dexametasona possivelmente retardou ou impediu a resolução da infecção. / Strongyloidiasis is an intestinal parasitosis with an obligatory pulmonary cycle, which represents the fourth largest parasitosis caused by nematodes. The mechanism of defense against strongyloidiasis is mediated by activation of Th2 cells, which amplify the cellular response through the secretion of inflammatory mediators. Strongyloidiasis is a serious public health problem due the development of hyperinfection, due to the use of glucocorticoids, where the number of worms and females increases, and disseminate to other organs. Studies have shown that some helminth infections have been accompanied by hypertrophy of intestinal muscles and hypercontractility, JAK-STAT 6 pathway. However little has been reported about on the influence of JAK-STAT 6 pathway in changes of the muscular wall of the duodenum during Strongyloides venezuelensis infection. The aim of this study was to identify the morphological, immunological and pathological changes of the intestinal smooth muscle during Strongyloides venezuelensis in Wistar rats and to determine the effects of Dexamethasone treatment and role of JAK-STAT 6 pathway in these process. Wistar rats were inoculated with S. venezuelensis larvae, treated with dexamethasone and killed at 5, 7, 14 and 21 days. Morphological and morphometric analyzes with routine stains to quantify globet cells, eosinophils and measure the circular and longitudinal layers of duodenal smooth muscle. Performed gene expression analysis of STAT 6. Goblet cell hyperplasia and increased of intestine smooth muscle wall thickness and eosinophils levels were elevated throughout the course of the infection. Moreover, an increase in the expression of STAT 6 in infected animals. The morphological findings and the immunomodulatory response to the infection were drastically reduced in dexamethasone-treated rats. However, the number of worms was significantly higher on infected and treated rats with Dexamethasone compared to just infected ones. The intestinal changes during infection ocurred in an attempt of expel the parasite and elucidate the infection. Although, the inhibition of the process caused by Dexamethasone possibly delay or prevent the resolution of infection

Par sa fréquence et sa gravité, le cancer colorectal (CCR) demeure un problème de santé publique. Notre objectif global est de mieux comprendre les mécanismes impliqués dans l'homéostasie intestinale au travers de Mucdhl, une cadhérine atypique méconnue mais qui semble jouer un rôle très particulier dans l'épithélium intestinal et être impliquée dans les CCR. De manière intéressante, son expression semble fréquemment perdue dans les CCR, tandis que son maintien dans les cellules cancéreuses coliques diminue leur potentiel tumoral.Pour mieux appréhender le mode d'action de Mucdhl, une caractérisation fonctionnelle de son interaction avec β-caténine oncogénique a été réalisée et de nouveaux partenaires ont été identifiés dans les cellules intestinales. Afin de comprendre le rôle de Mucdhl dans la physiologie intestinale, encore inconnu à ce jour, un modèle murin déficient pour Mucdhl a été étudié. L'analyse des conséquences de la perte d'expression de Mucdhl indique qu'il est impliqué dans la structure et le fonctionnement de l'intestin chez la souris, mais également au niveau de processus métaboliques. De plus, cette perte d'expression de Mucdhl augmente la sensibilité des souris au développement de certaines tumeurs intestinales. Ces travaux ont donc permis de générer des informations inédites sur les fonctions physiopathologiques de Mucdhl, une cadhérine atypique encore mal connue, mais potentiellement impliquée dans les CCR. / Because of its frequency and severity, Colorectal Cancer (CRC) remains an important public health issue. Our objective is to understand mechanisms contributing to intestinal homeostasis through Mucdhl, a poorly characterized atypical cadherin that may play a unusual role in the intestinal , epithelium and be implicated in CRC. lnterestingly, its expression seems to be frequently reduced in CRC, while its retention in colon cancer cells decreases their tumorigenic potential.To better apprehend the mode of action of Mucdhl, a functional characterization of its interaction with oncogen,iç β-catenin was performed and new partners have been identified in intestinal cells.To understand the role of Mucdhl in intestinal physiology, mice genetically-invalidated at the Mucdhl locus were studied. Analysis of the consequences of Mucdhl loss of expression indicates that it is involved in the morphology and function of the mouse intestine, but also in metabolic processes. Moreover, Mucdhl loss of expression increases the sensibility of mice to the development of certain intestinal tumors. Thus, we generated new information on the physiopathological functions of Mucdhl, an intriguing atypical cadherin potentially involved in CRC.

In the past, hyperlipidemia (HL) has been shown to affect the pharmacokinetic and pharmacodynamic properties of lipophilic drugs extensively bound to lipoproteins, including halofantrine (HF). The present thesis examined the effect of HL on the biodistribution, metabolism and electrocardiographic (ECG) effects of HF in the poloxamer 407 rat model of HL. The HL state caused unexpected changes in the distribution of HF enantiomers. In contrast to plasma, concentrations of desbutyl-HF (DHF) were much higher in highly perfused tissues. Following in vitro incubation of racemic HF and DHF, HF and DHF enantiomers shifted from the lipoprotein deficient fraction to triglyceride-rich fractions in HL plasma. No significant differences were noted in HF metabolism between NL and HL liver microsomes. It appears that both reduced plasma unbound fraction and lipoprotein associated directed uptake of lipoprotein-bound drug by tissues play roles in enantiomer biodistribution. In everted gut metabolism, formation of DHF enantiomers was inversely proportional to bile concentration whereas addition of lipids in the presence of bile caused a significant decrease in DHF:HF ratio of (-)-enantiomers. Pre-treatment of rats with peanut oil had no significant effect on DHF formation in the incubated sacs or microsomal preparations, nor did it affect the expression of intestinal CYP450. The above results were consistent with previous in vivo evaluations showing that the DHF to HF ratio was decreased by the ingestion of a high fat meal. In the ECG study, HL by itself had no effect on the ECG. In HL rats, plasma but not heart concentrations of the HF enantiomers were significantly higher compared to NL rats. DHF did not impart significant ECG prolonging effects after HF administration. The unbound fraction of HF was the controlling factor for drug uptake by the heart. Despite the lack of difference in HF heart concentrations, the QT and QTc intervals were significantly higher in HL compared to NL rats, suggesting a greater vulnerability towards HF induced QT interval prolongation in the HL state. The HL serum resulted in decreased metabolism of HF enantiomers in the isolated primary rat hepatocytes. Studies with LLC PK1 and NRK 52E cells showed that HF is not a substrate of P-glycoprotein transporters. / Pharmaceutical Sciences

Thesis (Ph. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

Malignant tumours of the small intestine are rare. Age-standardised incidence in Europe is between 0.5-1.5 per 100 000. As the small intestine represents more than 90 % of the gastrointestinal mucosal surface, it is surprising that it gives rise to less than 2 % of gastrointestinal malignancies. The dominating histological subtypes are carcinoids and adenocarcinomas. We used three population-based registries in Sweden to study survival, second malignant tumours, causes of death, and Crohn’s disease as a risk factor for small intestinal adenocarcinoma and carcinoid. We evaluated tumour site, sex, age, and year of diagnosis as prognostic factors. For adenocarcinomas there was no difference in survival between duodenal and jejunal/ileal tumours. Women with jejunal/ileal adenocarcinomas showed higher probabilities of survival than men, while no such relation was found for duodenal tumours. Old age correlated with poor survival for duodenal tumours, and prognosis has improved in later years. For carcinoids, duodenal tumours had a more favourable prognosis than jejunal/ileal tumours. There was no difference in survival between sexes. Old age correlated with poor survival, and survival has improved in recent years. Female patients with adenocarcinoma had increased risk of acquiring cancer in the genital organs and breasts, and both sexes had increased risks of second tumours in the gastrointestinal tract and skin. Men with carcinoid tumours had increased risk of prostate cancer. Both sexes had increased risk of malignant melanoma and malignancies of endocrine organs. Patients with adenocarcinoma had increased risk of dying from malignant diseases other than the primary small intestinal cancer and from gastrointestinal disease. The cohort with carcinoid had higher than expected risk of dying from malignant disease, gastrointestinal disease, and cardiovascular disease. Patients with Crohn’s disease had increased risk of small intestinal adenocarcinoma and carcinoid, and the risk has increased for patients diagnosed in recent years.

Glucagon-like peptide-1 (GLP-1) is secreted from the enteroendocrine L cell following nutrient ingestion. Although GLP-1 regulates several aspects of nutrient homeostasis, one important function is to enhance glucose-dependent insulin secretion. In type 2 diabetes, post-prandial GLP-1 secretion is impaired. Insulin resistance, which is required for the pathogenesis of type 2 diabetes, is also associated with impaired GLP-1 secretion. I, therefore, hypothesized that insulin modulates GLP-1 secretion from the intestinal L cell and, furthermore, insulin resistance directly impairs the function of the endocrine L cell. In well-characterized L cell models, I established that insulin stimulates GLP-1 secretion through the MEK1/2-ERK1/2 pathway, and induction of insulin resistance in vitro attenuated insulin- and heterologous secretagogue-induced GLP-1 release. Furthermore, glucose-stimulated GLP-1 secretion was decreased in hyperinsulinemic-insulin resistant MKR mice, demonstrating that insulin resistance is associated with impaired L cell function. I next examined the role of the actin cytoskeleton in insulin-stimulated GLP-1 secretion. Insulin treatment transiently induced actin depolymerization, and depolymerization of the actin cytoskeleton potentiated insulin-stimulated GLP-1 release from the L cell, demonstrating that the cytoskeleton functions as a permissive barrier. Central to insulin’s effects on actin dynamics is the Rho GTPase, Cdc42, as siRNA-mediated knockdown and over-expression of a dominant-negative mutant, prevented insulin-stimulated actin remodeling and GLP-1 release. Insulin also promoted activation of PAK1, the downstream kinase of Cdc42, and over-expression of a kinase-dead PAK1 mutant attenuated insulin-stimulated GLP-1 release. In cells that expressed dominant-negative Cdc42 or kinase-dead PAK1, activation of ERK1/2 following insulin treatment was attenuated, demonstrating that the Cdc42-PAK1 axis regulates the activity of the canonical ERK1/2 pathway. In summary, this thesis demonstrates, for the first time, that insulin is a GLP-1 secretagogue, and this effect of insulin is mediated through the canonical ERK1/2 pathway and the Cdc42-PAK1 axis. Insulin resistance in the L cell impairs the responsiveness of the L cell to heterologous secretagogues. Collectively, these findings suggest that an alternative approach to treat type 2 diabetes and/or insulin resistance may be to directly improve the function of the L cell, thereby enhancing endogenous GLP-1 release.

The gut hormone glucagon-like peptide-2 (GLP-2) has numerous beneficial effects on the intestinal epithelium, including increased mucosal growth and proliferation. GLP-2 is also necessary for the adaptive intestinal re-growth that occurs upon re-feeding after fasting. Although insulin-like growth factor (IGF)-1 and the IGF-1 receptor are known to be required for GLP-2-induced crypt-cell proliferation, the precise cellular localization of the IGF-1 receptor through which the intestinotrophic actions of GLP-2 are mediated remains unknown. I hypothesized that small intestinal growth responses to GLP-2 occur through an intestinal epithelial IGF-1 receptor-dependent pathway, through the use of an inducible, intestinal epithelial-specific IGF-1 receptor knockout (IE-igf1rKO) mouse. Intestinal growth and proliferative responses were examined in IE-igf1rKO and control mice following treatment with GLP-2, as well as in animals that were fasted and re-fed to induce GLP-2-dependent adaptation. In Chapter 3, it was demonstrated that IE-igf1rKO mice, as compared to control littermates, had normal small intestinal weight, morphometric parameters, proliferative index and differentiated epithelial cell lineage distribution. Administration of GLP-2 for 30 minutes increased nuclear translocation of !-catenin in non-Paneth crypt-cells, and stimulated the crypt-cell proliferative marker c-Myc 90 minutes following GLP-2 treatment, in control littermates but not in IE-igf1rKO mice. In Chapter 4, adaptive re-growth was studied by fasting IE-igf1rKO and control animals for 24 hours, or by fasting and then re-feeding mice for 24 hours. Small intestinal weight, crypt depth, villus height and crypt-cell proliferation were decreased in both control and IE-igf1rKO mice after 24 hour fasting. While re-feeding in control mice restored all of these parameters, re-fed IE-igf1rKO mice displayed abrogated adaptive re-growth of the crypt-villus axis as well as reduced crypt-cell proliferation. In Chapter 5, control mice responded to chronic GLP-2 with increased small intestinal weight, mucosal cross-sectional area, crypt depth, villus height and crypt-cell proliferation. However, the GLP-2-induced increase in crypt-cell proliferation was absent in IE-igf1rKO mice, in association with impaired growth of the crypt-villus axis. Taken together, these results indicate that the proliferative responses of the intestinal epithelium to exogenous GLP-2 administration and during conditions of GLP-2-dependent adaptive re-growth are dependent on the intestinal epithelial IGF-1 receptor.